ArticleCardiovascular diabetology2021
History of lower-limb complications and risk of cancer death in people with type 2 diabetes.
Article in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 26 citations in OpenAlex.
- Risk score for lower-limb amputation and its ability to predict major kidney and cardiovascular events in people with type 1 diabetes.Cardiovascular diabetology · 2026Article
- Epidemiology and Burden of Peripheral Artery Disease in People With Type 2 Diabetes: A Systematic Literature Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024Review
- Fresh fruit, dried fruit, raw vegetables, and cooked vegetables consumption associated with progression trajectory of type 2 diabetes: a multi-state analysis of a prospective cohort.European journal of nutrition · 2024Article
- Cost-effectiveness of screening of coronary artery disease in patients with type 2 diabetes at a very high cardiovascular risk (SCADIAB) study. Updated study design: emulation of a randomised target trial using electronic health records.Cardiovascular diabetology · 2023Article
- Differential prognostic burden of cardiovascular disease and lower-limb amputation on the risk of all-cause death in people with long-standing type 1 diabetes.Cardiovascular diabetology · 2022Article
- Medial Arterial Calcification: A Significant and Independent Contributor of Peripheral Artery Disease.Arteriosclerosis, thrombosis, and vascular biology · 2022Review
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Authors and funding
7 authors at 7 institutions in 5 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIndividuals with diabetes and lower-limb complications are at high risk for cardiovascular and all-cause mortality, but uncertainties remain in terms of cancer-related death in this population. We investigated this relationship in a large cohort of people with type 2 diabetes.
methodsWe used data from the Action in Diabetes and Vascular Disease: PreterAx and DiamicroN Modified-Release Controlled Evaluation (ADVANCE) study. The primary outcome was adjudicated cancer death; secondary outcomes were overall and site-specific incident cancers, determined according to the International Classification of Diseases Code (ICD-10). We compared outcomes in individuals with (versus without) a baseline history of lower-limb complications (peripheral artery disease (PAD) or sensory peripheral neuropathy) using Cox regression models.
resultsAmong 11,140 participants (women 42%, mean age 66 years), lower-limb complications were reported at baseline in 4293 (38%) individuals: 2439 (22%) with PAD and 2973 (27%) with peripheral neuropathy. Cancer death occurred in 316 (2.8%) participants during a median of 5.0 (25th-75th percentile, 4.7-5.1) years of follow-up corresponding to 53,550 person-years and an incidence rate of 5.9 (95% CI 5.3-6.6) per 1000 person-years. The risk of cancer death was higher in individuals with (versus without) lower-limb complication [hazard ratio 1.53 (95% CI, 1.21-1.94), p = 0.0004], PAD [1.32 (1.02-1.70), p = 0.03] or neuropathy (1.41 (1.11-1.79), p = 0.004], adjusting for potential confounders and study allocations. PAD, but not neuropathy, was associated with excess risk of incident cancers.
conclusionsPAD and peripheral neuropathy were independently associated with increased 5-year risk of cancer death in individuals with type 2 diabetes. PAD was also associated with increased risk of incident cancers. Our findings provide new evidence on the non-cardiovascular prognostic burden of lower-limb complications in people with type 2 diabetes.
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